Bertrand X, Blasco G, Belle E, Boillot A, Capellier G, Talon D
Service d'hygiène hospitalière et d'épidémiologie moléculaire, centre hospitalier universitaire Jean-Minjoz, boulevard Fleming, 25030 Besançon, France.
Ann Fr Anesth Reanim. 2003 Jun;22(6):505-9. doi: 10.1016/s0750-7658(03)00136-9.
To update the local epidemiological data of Pseudomonas aeruginosa in intensive care units (ICU) by assessing the colonisation incidence rate and the level of cross-transmission.
Study carried out in both adult ICUs of the university-hospital of Besançon during a 2 years period. Clinical and surveillance specimens were screened for P. aeruginosa. Pulsed-field-gel-electrophoresis was used as genotyping method to evaluate the rate of cross-transmission.
During the study, 314 patients were positive for P. aeruginosa (incidence rate of 19.1 patients per 100 admitted patients). One hundred sixty-six of these patients were detected with a clinical specimen and 148 with a screening specimen. Seventy-seven patients were colonised upon admission in the intensive care unit and 237, negative on admission, became positive during their stay. Of the ICU-acquired cases, the mean length of stay before P. aeruginosa colonisation was acquired was 15.7 days. Genotyping revealed that 53.5% of P. aeruginosa colonisation was acquired via cross-transmission (respectively 48.1% in the medical ICU and 59.2% in the surgical ICU); the other cases probably originated from endogenous sources.
The incidences of P. aeruginosa colonisation upon admission and during hospitalisation are consistent with other french and european studies. Although we probably over-estimated the rate of cross-transmission, our results demonstrate that cross-transmission may be a major cause of P. aeruginosa dissemination in ICUs.
通过评估定植发生率和交叉传播水平，更新重症监护病房（ICU）中铜绿假单胞菌的本地流行病学数据。
在贝桑松大学医院的两个成人ICU中进行了为期2年的研究。对临床和监测标本进行铜绿假单胞菌筛查。采用脉冲场凝胶电泳作为基因分型方法来评估交叉传播率。
在研究期间，314例患者铜绿假单胞菌检测呈阳性（每100例入院患者中发病率为19.1例）。其中166例患者通过临床标本检测出，148例通过筛查标本检测出。77例患者在进入重症监护病房时已被定植，237例入院时为阴性，在住院期间转为阳性。在ICU获得性病例中，在获得铜绿假单胞菌定植之前的平均住院时间为15.7天。基因分型显示，53.5%的铜绿假单胞菌定植是通过交叉传播获得的（在内科ICU中分别为48.1%，在外科ICU中为59.2%）；其他病例可能源于内源性来源。
入院时和住院期间铜绿假单胞菌定植的发生率与其他法国和欧洲的研究一致。尽管我们可能高估了交叉传播率，但我们的结果表明，交叉传播可能是ICU中铜绿假单胞菌传播的主要原因。
